Wrist instability

Effective use of our wrist and hand is important for all aspects of our life. If our wrist joint becomes unstable, it can alter the movement and function of our hand, and our entire upper limb.

An unstable wrist can also cause pain and weakness with gripping and fine motor tasks, or prevent us from being able to bear weight on our hands. Understanding the causes, and common symptoms in wrist instability is crucial for effective management, and will assist in choosing the best treatment option that is suited to your needs. 

There are 2 main causes of wrist instability 

1. Acute trauma; This is the most common cause of wrist instability. Mechanisms such as:
   1.  a fall on an outstretched hand
   2. forced excessive deviation of the wrist when swinging a racquet/bat or even using a hand tool
   3. higher force trauma like a car accident or fall from a height

 These injuries can cause tears in the ligaments that stabilise the wrist joint, fractures/dislocation of the wrist, or compression injuries to the cartilage.

2. Overuse or repetitive stress: Lower force activities that are repeated frequently can cause microtrauma to the soft tissue structures of the wrist, which over time can create pain and instability. These activities include:
   1. Typing and mouse usage
   2. Repetitive manual tasks e.g. hammering, screwdriver use, cooking, sewing
   3. Sports
      1. Racquet based (tennis, squash, badminton)
      2. Sports involving weight bearing on the wrist (gymnastics, dance, diving)
      3. Paddle based sports (rowing, kayaking)  

What are some symptoms of wrist instability?

These may vary depending on the severity of the condition, but they commonly include:

1. Pain or discomfort in the wrist, which may worsen during activities that require wrist movement or weight-bearing.
2. Weakness or a feeling of instability in the wrist joint.
3. Swelling and tenderness around the wrist.
4. Clicking or popping sensation during wrist movement.
5. Reduced range of motion.
6. Difficulty in performing activities that involve gripping or rotating of the wrist.

Diagnosis and treatment:

Diagnosing wrist instability can be difficult, as imaging such as x-rays and ultrasound may be normal. A thorough history and clinical examination to see how your wrist moves is usually the best way to diagnose the problem. Often if your symptoms improve with bracing or taping, that can also indicate there is instability present. MRI can be helpful in evaluating the ligaments and cartilage, and may detect things that an x-ray or ultrasound can’t show, however it is not always necessary. 

Once the diagnosis has been established, there are several options for treatment. These include:

1. If your wrist is quite painful or irritable, an initial period of rest and/or immobilisation may be needed. A brace or tape is usually sufficient, however more complex cases may need a thermoplastic splint made specifically for your wrist
2. Once things have settled, it is a good option to commence physio. Physiotherapy can:
   1. help with reducing pain and tightness in overloaded muscles
   2. advise on ergonomics and posture
   3. prescribe a specific strengthening program to build up the muscles that support the wrist. Getting stronger muscles can reduce the amount movement and instability across the wrist joint
3. If there are signs on ongoing inflammation, some medications such as Non-steroidal anti-inflammatories (NSAIDs) can reduce the pain and inflammation
4. If inflammation is ongoing, some cases may benefit from corticosteroid injections. This is usually not a first line treatment, and best done in conjunction with ongoing physiotherapy. 
5. Lastly, complex cases of wrist instability, or those that are unresponsive to conservative treatment may require a surgical intervention. The procedure aims to repair or reconstruct the damaged ligaments and restore stability to the joint.

Prevention and ongoing care

If you play wrist based sports, or are at risk of repetitive overuse of the risk, putting strategies in place to prevent the development of wrist instability is key. The same strategies can also be used for those recovering from wrist instability to help minimise the risk of reinjury. These strategies include:

1. Optimising your ergonomic set up of your work environment, and utilising efficient ergonomics during daily activities.
2. Using protective equipment when participating in sports or activities with a high risk of wrist injury.
3. Ensuring correct technique and adequate strength is maintained for your sporting activities
4. Load management – ensuring you gradually increase activity levels and avoid overexertion.
5. Following  a continued rehabilitation program prescribed by your Physiotherapist to  continue to strengthen and regain stability. 

Wrist instability is a condition that can significantly affect daily functioning and quality of life. Timely diagnosis, appropriate treatment, and rehabilitation measures are crucial for managing this condition effectively and reducing the risk of long-term complications.

If you suspect wrist instability or experience persistent wrist pain or weakness RHP can assist with providing you an accurate diagnosis and personalised treatment plan. Give us a call on (07) 3856 5566 for an appointment today. 

Wrist instability: Causes, Symptoms, and treatment

Wrist instability is a condition where the wrist joint becomes unstable, resulting in abnormal movement and function. It can cause pain, weakness, and limitations in performing everyday activities. Understanding the causes, symptoms and treatment options for wrist instability is crucial for effective management.

Causes of wrist instability:

1. Trauma: The most common cause of wrist instability is a traumatic injury, such as a fall on an outstretched hand. This can cause ligament tears or dislocation of the bones in the wrist, leading to instability.

2. Ligament injuries: Sprains or tears of the ligaments that support the wrist joint can result in

instability. Ligaments provide stability to the joint by connecting bones and preventing excessive movement.

3. Overuse or repetitive stress: Chronic overuse or repetitive stress on the wrist joint, commonly seen in activities like typing, playing sports, or repetitive manual labour can irritate the structures of the joint and contribute to wrist instability.

Symptoms of wrist instability:

These may vary depending on the severity of the condition, but they commonly include:

1. Pain or discomfort in the wrist, which may worsen during activities that require wrist movement or weight-bearing.

2. Weakness or a feeling of instability in the wrist joint.

3. Swelling and tenderness around the wrist.

4. Clicking or popping sensation during wrist movement.

5. Reduced range of motion.

6. Difficulty in performing activities that involve gripping or rotating of the wrist.

Diagnosis and Treatment:

Diagnosing wrist instability typically involves a thorough physical examination, evaluation of medical history, and imaging tests such as X-rays, MRI, or arthroscopy. Once diagnosed, treatment options can include:

1. Rest and Immobilization: Initially, resting the wrist and immobilising it with a splint or brace

can help reduce pain and allow the ligaments to heal.

2. Physical Therapy: A structured physical therapy program can help strengthen the muscles

around the wrist joint, improve stability, and restore function.

3. Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) may be prescribed to alleviate pain and reduce inflammation.

4. Corticosteroid Injections: In some cases, corticosteroid injections may be recommended to reduce inflammation and pain.

5. Surgical Intervention: Severe cases of wrist instability or those unresponsive to conservative treatment may require surgical intervention. The procedure aims to repair or reconstruct the damaged ligaments and restore stability to the joint.

Prevention and Rehabilitation: 

To prevent wrist instability or reduce the risk of recurrence:

1. Practise proper ergonomics and wrist positioning during daily activities.

2. Use protective gear when participating in sports or activities with a high risk of wrist injury.

3. Gradually increase activity levels and avoid overexertion.

4. Follow a rehabilitation program prescribed by a healthcare professional to regain strength and stability in the wrist.

In conclusion, wrist instability is a condition that can significantly affect daily functioning and quality of life. Timely diagnosis, appropriate treatment, and rehabilitation measures are crucial for managing this condition effectively and reducing the risk of long-term complications. If you suspect wrist instability or experience persistent wrist pain or weakness, it is advisable to consult a healthcare professional for an accurate diagnosis and personalised treatment plan.